This competing continuation application is to complete follow-up for the first randomized controlled trial of needle exchange that is taking place in Anchorage Alaska. This research uses the design of a two group randomized clinical trial in which current injection drug users have been randomly assigned to: (a) being able to use syringe exchange (at any of three different locations), or (b) not having access to the syringe exchange and being instructed how to use legal pharmacy sales instead. By the time the first year of this continuation ends, all subjects will have had six-month and 12-month follow-up. Information will be collected with the Risk Behavior Follow-Up Assessment (RBFA), a supplementary questionnaire concerning needle use and procurement, urine testing for amphetamines, cocaine metabolites, and morphine, and serological testing for Hepatitis C Virus, and Hepatitis B Virus. Markers of Human Immunodeficiency Virus will also be monitored. A Data Safety and Monitoring Board will continue to meet at least every six months and have oversight over the ethical issues involved in the research.